Prevalence of dyslipidemia and achievement of low-density lipoprotein cholesterol targets in Chinese adults: A nationally representative survey of 163,641 adults

Zhang, Mei; Deng, Qian; Wang, Lınhong; Huang, Zhengjing; Zhou, Maigeng; Li, Yichong; Zhao, Zhenping; Zhang, Yawei

doi:10.1016/j.ijcard.2017.12.069

Cited by 181 publications

(145 citation statements)

References 33 publications

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“…For example, the prevalence of diabetes mellitus and obesity in this population was lower than that in the general Chinese population (5.6% vs. 11.6% and 4.7% vs. 12.0%, respectively) [40]. Moreover, HDL-c was higher in these participants than in the general population (60.6 ± 15.7 mg/dl vs. 51.7 ± 11.4 mg/dl) [41], and fewer were on statin treatment (2.6% vs. 6.84%) [42]. Therefore, our findings may be generalized to only relatively healthy and young populations.…”

Section: Discussionmentioning

confidence: 97%

Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

Wen

Huang

et al. 2019

Hypertens Res

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Several lipid parameters are closely associated with residual cardiovascular risk. We aimed to confirm that in a range of lowdensity lipoprotein cholesterol (LDL-c) levels (from <70 mg/dl to ≥160 mg/dl), other lipid parameters, such as triglyceride (TG) level, non-high-density lipoprotein cholesterol (non-HDL-c) level, and the total cholesterol (TC)/HDL-c ratio, are still related to arterial stiffness, which is a recognized marker of atherosclerosis. In this cross-sectional study, we measured brachial-ankle pulse wave velocity (baPWV), as well as clinical and biochemical indices in 16,733 Chinese adult volunteers who underwent health checkups from January 2014 to January 2015. Arterial stiffness was defined as the upper quartile of baPWV. We applied multivariable logistic regression models to examine the associations between lipid parameters and arterial stiffness. Both men and women with high baPWV were more likely to have an atherogenic lipid phenotype. Among participants with LDL-c <70 mg/dl, participants with non-HDL-c ≥100 mg/dl had a multivariable adjusted OR for arterial stiffness of 1.66 (1.11-2.50) compared to those with non-HDL-c <100 mg/dl; participants with TG ≥150 mg/dl had an OR of 2.44 (1.61-3.71) compared to those with TG <150 mg/dl; and participants with a TC/HDL-c ratio ≥4 had an OR of 1.74 (1.15-2.65) compared to those with a TC/HDL-c ratio <4. Similar results were observed at other LDL-c levels. We found that non-HDL-c, TG, and the TC/HDL-c ratio were consistently associated with arterial stiffness in a range of LDL-c levels, even when LDL-c was below 70 mg/dl. These lipid measures are related to residual cardiovascular risk, possibly due to their detrimental effects on vascular structure. Keywords Low-density lipoprotein cholesterol • Non-high-density lipoprotein cholesterol • Triglycerides • Total cholesterol/ HDL-c ratio • Brachial-ankle pulse wave velocity • Arterial stiffness • Cardiovascular disease

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Section: Discussionmentioning

confidence: 97%

Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

Wen

Huang

et al. 2019

Hypertens Res

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“…strategies [1][2][3] . However, although a majority of CVDfree asymptomatic individuals maintain low levels of LDLC 4) , they have a high prevalence of subclinical atherosclerosis 5) . In addition, a number of individuals who have experienced cardiovascular events demonstrate low levels of LDLC 6,7) .…”

Section: Laboratory Assaysmentioning

confidence: 99%

High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study

Liu

Wang

et al. 2020

JAT

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A high-risk strategy has been implemented for lipid-lowering therapy in the primary prevention of cardiovascular disease. However, atherosclerosis and cardiovascular events are common among individuals with low cardiovascular risk. This study aimed to determine whether the small dense low-density lipoprotein cholesterol (sdLDLC) level can predict carotid atherosclerosis progression and identify high-risk individuals. Methods: Baseline sdLDLC and low-density lipoprotein cholesterol (LDLC) were measured in 808 particip ants from the Chinese Multi-provincial Cohort Study, aged 45 74 years. Adjusted relative risk was calculated using a modified Poisson regression model to assess the relationship between sdLDLC and 5-year atherosclerosis progression, as indicated by the progression, incidence, and multi-territorial extent of carotid plaque. Results: The 5-year atherosclerosis progression increased significantly with increased sdLDLC. Baseline sdLDLC was significantly associated with the short-term risk of plaque progression after multivariable adjustment, even in participants with low LDLC or a 10-year estimated cardiovascular risk. sdLDLC predicted plaque progression (relative risk 2.05; 95% confidence interval 1.43 2.93) in participants with LDLC 130 mg/dL. Furthermore, participants with the highest sdLDLC but intermediate or low cardiovascular risk (accounting for 16% of the cohort) had double the risk of plaque progression, which was comparable to those with the same sdLDLC and high cardiovascular risk, relative to those with the lowest sdLDLC levels and low cardiovascular risk. Conclusions: sdLDLC is independently associated with the progression of carotid atherosclerosis, which may provide a basis for clinicians to reclassify individuals believed to be at low cardiovascular risk into the high-risk category, and those with high sdLDLC may benefit from more aggressive cholesterol-lowering treatment. through the appropriate management of modifiable risk factors. Low-density lipoprotein cholesterol (LDLC) is considered as one of the most important modifiable risk factors for CVD and remains the primary target for current cardiovascular risk reduction

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“…For India, evidence of 2008-2010 from the Indian Council of Medical Research India Diabetes Study (ICMR-INDIAB study) was included [37]. Data from Nigeria were obtained from a study based on population-based surveys of four geopolitical areas [38], and data from China came from a 2014 metanalysis [39] and a nationally representative survey carried out between 2013 and 2014 [40]. In the case of Brazil, this information was collected from a prospective study with 15,105 participants [41] and the prevalence of self-reported high cholesterol levels was identified in a study based on the National Health Survey 2013 [42].…”

Section: Literature Searchmentioning

confidence: 99%

Attributable burden and expenditure of cardiovascular diseases and associated risk factors in Mexico and other selected mega-countries

Mendoza-Herrera

Pedroza-Tobías

Hernández-Alcaraz

et al. 2019

Preprint

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Background Cardiovascular diseases (CVD) represent a health and economic threat globally. This paper aims to describe this problem in Mexico and other selected mega-countries through a review of published literature and the exploration of secondary datasets. Method Mega-countries with low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S./Japan) human development index (HDI) were included. The review was divided into two topics: prevalence of dyslipidemia and CVD economic impact. Search, screening, and filtering processes were conducted in electronic databases using MeSH terms by one trained researcher. Inclusion and exclusion criteria were considered for eligibility. Methods and results were reported according to the PRISMA statement. Information from datasets on epidemiologic CVD indicators was also extracted. Results Thirty-two studies were eligible. Heterogeneity in economic data and limited nationwide information on dyslipidemias prevalence in some countries were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared to other countries. Dietary risk factors have a higher contribution on cardiovascular mortality in developing countries: e.g. 8.1-13.8% Mexico, 11.3-13.0% India vs. 0.078-8.9% Japan, 6.5-10.7% the U.S. Probability of dying prematurely from CVD in 2016 was higher in lower HDI countries: 23.3-22.5% (low-middle), 17.0-15.7% (high), and 14.6-8.4% (very high). From 1990-2016, a greater decrease in cardiovascular mortality in developed countries was registered (-56.8% Japan/-11.1% India). In 2015, an expenditure of USD-PPP $11.2 billion due to hypertension, myocardial infarction, atrial fibrillation, and heart failure was reported in Mexico (4% from public health expenditure). CVD ranked first in health care expenditures in almost all these nations and this economic burden is expected to remain significant by 2030, especially in the most populated or developed countries. Conclusions The higher burden of CVD and its significant economic impact, coupled with poor clinical practice and epidemiological surveillance, represents a greater challenge for Mexico and other developing mega-countries. Thus, governments and academia should secure resources to assure an optimal monitoring of cardiovascular risk factors. Educational models and medical practice must be improved to optimize the diagnosis of CVD and the prescription and adherence of their pharmacological and lifestyle treatments. Long-term benefits are expected from strengthening strategies to modify the food system.

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Prevalence of dyslipidemia and achievement of low-density lipoprotein cholesterol targets in Chinese adults: A nationally representative survey of 163,641 adults

Cited by 181 publications

References 33 publications

Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study

Attributable burden and expenditure of cardiovascular diseases and associated risk factors in Mexico and other selected mega-countries

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